HomeMy WebLinkAboutMortgage_Bobe Y E - STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°----',�� FOR DEDUCTION FROM ASSESSED VALUATION
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%orii State Form 43709(R14/1-20) Gibson Princeton 2020
• iii-'/ Prescribed by Department of Local Government Finance
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File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is 1 r t County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the cout wh re QJ�e pr e ,
located on or before January 5 of the calendar year in which the property taxes are first ra..c,pa b e. 'a ❑ County Recorder
See reverse side for additional instructions and qualifications. DEC
Applicant(owner or contract buyer-see restrictions on reverse side) a 2020
Susan G Bobe
Taxing District Key number/legal description GAB Record number Page number
Princeton 26-12-08-103-000.360-028 S0N c00A, 0 C9 0
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebth `dtf s maid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application r I OR legal or equitable owner?
$ 100,000 VI Yes ❑No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
®Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
German American Bank
Address of mortgagee or contract seller(number t ) D — �/t O S
Ov `�
Name of assignee or other owner or holder of mor
Drawer NO
Address of assignee(number and street,city,stab
Does applicant own property in any If yes,what Card NO. duction been requested If yes,state amount of deduction
other county ,for
in Indiana? Yes No J.??❑ ® ®Yes ❑No
A person is not entitled to this deduction unle.,.,.,,..,..,.....,.„u..a wCJ,o„I,G VI LUG NG,atl„°„nJI(Waye or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Sign ture of County Auditor A County Date(month,day,year)
Gibson 12/15/2020
I/We certify under the penalty perjury that theyY Foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
SIOOalura w is f II na e) � Date(month,day,year)
Full rediden ddress of apiSlicar(t(number and street,city,state,and ZIP code)
853 E State St., Princeton,IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,yea)
Address of authorized person (number and street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.